上海市社区全科医生控烟服务态度及其影响因素研究

GPs' Attitudes to Smoking Cessation Services and Its Influencing Factors in Shanghai Communities

目的调查上海市社区全科医生的控烟服务态度,并对其影响因素进行分析。方法 2013年2—7月,采用横断面调查,使用自行设计的调查表对上海市36家社区卫生服务中心的827例社区全科医生进行控烟服务态度的相关调查。结果 827例社区全科医生中男310例(37.5%)、女517例(62.5%)。78.2%(647例)同意医生应当常规询问患者的吸烟情况,86.1%(712例)同意医生应当常规劝诫吸烟患者戒烟,80.0%(662例)同意医生应当接受控烟相关知识和技能的培训,74.8%(618例)同意医疗保险应当支付医生提供的控烟服务。不同年龄、职称、执业类别、临床工作年限、是否接受控烟技能培训及控烟服务知识掌握情况不同的社区全科医生控烟态度间差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、执业类别、曾接受过控烟技能培训以及掌握控烟服务知识较好是社区全科医生控烟服务态度的影响因素(P<0.05)。结论上海市社区全科医生对提供控烟服务尚缺乏全面的认识和积极的态度,对提供控烟服务的有效性缺乏足够自信。年龄<30岁、西医全科、曾接受控烟技能培训及控烟知识掌握好的社区全科医生具有积极的控烟态度。

Objective To investigate CPs＇ attitudes to smoking cessation services and its influencing factors in Shanghai communities. Methods A cross - sectional survey was carried out on CPs＇ attitudes to smoking cessation services in 827 CPs in 36 community health service centers in Shanghai from February to July 2013. Results In 827 respondents, there were 310 males （37.5%）, females 517 （62.5%）. 78.2% （647） agreed that CPs should ask conventionally patients their smoking status, 86. 1 % （712） agreed that CPs should exhort smokers to quit smoking, 80. 0% （662） agreed that CPs should be trained in tobacco control - related knowledge and skills, 74. 8% （618） agreed that medical insurance should pay CPs＇ smoking control services. There was significant difference in attitudes to smoking cessation between CPs at different ages, with different technical titles, types of physician certificate, clinical work experience, whether having received training for smoking control skill and grasping knowledge of smoking control （p 〈 0. 05）. By multivariate Logistic regression analysis, age, type of physician certificate, training for smoking control skill and grasping knowledge of smoking control were factors influencing CPs＇ attitudes to smoking cessation services （P 〈 0. 05）. Conclusion CPs are still short of comprehensive awareness, positive attitude to smoking control services or sufficient confidence in effectiveness of providing smoking control services in Shanghai communities. CPs at 〈 30 years old, Western medicine educated, having training for smoking control skill and grasping knowledge of smoking control have positive attitude to smoking cessation services.